Provider Demographics
NPI:1659561652
Name:WILLIAMS, HEATHER A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2068
Mailing Address - Country:US
Mailing Address - Phone:510-292-0369
Mailing Address - Fax:815-301-3354
Practice Address - Street 1:822 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2068
Practice Address - Country:US
Practice Address - Phone:510-292-0369
Practice Address - Fax:815-301-3354
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017228103TC0700X
CAPSY22113103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical